Matt Hancock’s vision for IT is the worst idea I’ve heard in a long time

Health secretary Matt Hancock doesn’t think much of IT in general practice. In a video released on Twitter, in the build up to the launch of the NHS long-term plan, he said: ‘GPs are often struggling with outdated and frustrating technology and we’re going to overhaul it’.

GPs don’t have outdated or frustrating technology. We don’t need new IT systems. We need existing systems to be better integrated with those used by other healthcare providers. The NHS has been working on this for a decade and we’re almost there. Referrals, prescriptions, discharge summaries and test results are now routinely sent electronically.

We’ve all moved over to a unified coding system for recording data (SNOMED) and we’re now heading towards a fully integrated exchange of information.

Every time a new IT package is introduced it has to run smoothly with dozens of others across GP practices, hospitals, pharmacies, district nurses, care homes and more. Inevitably any new systems have teething troubles that can cause all sorts of problems for patient care.

When systems aren’t set up properly or aren’t communicating with each other as expected medical records can be lost, or prescriptions, test results and referrals fail to reach their destination. It can mean confidential data being leaked and ending up in the hands of people never intended to see it.

‘It would lead to a bonanza for tech start-ups but a nightmare for GPs’

Our current software packages, such as EMIS, Vision, SystmOne and Docman, are already constantly updating and innovating. They partner with other firms to produce new products all the time. The last thing primary care needs is further disruption. We want stability, to concentrate on the huge challenges we face.

New systems mean staff have to learn new packages. When we consider changing clinical IT there must be an overwhelmingly compelling case. I’ve worked in practices during the transition from one system to another and it takes at least six moths of staff training and disruption, with all the mistakes and delays for patients that leads to. Not to mention additional training for a workforce already fed up with constant change – and mostly counting down the days until retirement.

If you’re lucky enough to be in an area where CCG IT support help with your clinical systems, they go from having to be good at a handful of packages to dozens. That increases training costs and reduces the chance of any one person being able to fix a problem, leading to more problems and delays.

GPs are happy with the software we have. We’ve spent a decade learning it and getting very good at it. We are happy to pick and choose plug-ins for our existing systems that meet our needs, and only require two or three staff to be trained. An overhaul is a huge and dangerous waste of time and money.

I can’t imagine many GP surgeries have been consulted about this. I’m confident that not many of them would think it’s a good idea.

I realise that Matt Hancock is a huge believer in the potential of software to improve the NHS. But I fear his proposed changes to practice systems aren’t driven by feedback in consultations with GPs and patients about how to improve access to the one-to-one, personal doctor-patient relationship – the jewel in the NHS crown.

Instead I worry that, after giving outside software companies the contracts for online video consultations instead of giving that option to GPs first, his vision is instead driven by a desire to exploit the commercial potential for outside organisations to finally get access to GP lists. I’m sure that would lead to a bonanza for tech start ups but it’s another unnecessary nightmare for practice teams and yet more erosion of the doctor-patient relationship.

Ed Poole is IT & Operations Manager at Brunswick Park Medical Practice, north London, NHS Barnet CCG. He has previously run for office as a Labour Party candidate

He is typical of those who think that a mobile phone app approach is modern; hence right. The problem is that most apps interrogate a limited number of databases. By contrast any new systems in the NHS need to access very large numbers of organisations, each with their iwn database. Just look at the marvelous NHS App which I downloaded. It currently can offer me NHS choices advice but not appointments, scripts, repeat access, econsultations etc etc

Upgrade what we have. What we have works. It’ll be a waste of money to overhaul. But maybe that’s the point? He wants to overhaul to ‘waste’ money in a certain direction? Just a thought. Won’t hekp health and social care to constantly overhaul. Please. Let’s not overhaul again.

The problem is that the above - very good - article doesn't support the simplistic narrative that Matt Hancock wants to hear and believe.
He wants to believe GPs are backward in IT and the systems are poor, so that he can rush in and 'rescue' the system. Of course, because the systems are generally fine, there will be a few minor inexpensive tweaks and he will declare it a success, job done.
As the article sets out, the real problems are in the other parts of the service, who are using fragmented outdated and unintegrated IT, and who are slow to innovate because of the intransigence of existing cultures and the poor leadership and management. But that doesn't match the preferred politician's narrative of 'GP bad, Hospitals good'.
This is all SO frustrating...

Hancock just needs a new “thing” to make him special and different from Hunt as health secretary - so he has decided on technology. There is literally no more depth to his interest and understanding than that.

The worst thing about Matt Hancock's vision is that it rather implies that he doesn't have much of a decent understanding of the medical IT system as it really is. As the article quite correctly states, the real problem isn't with the GP systems (though as always there are improvements which could be made), but with what they are connected to (or not connected to as the case may be).